Murder charges are pending against a psychiatric patient who killed his caseworker and tried to kill his doctor, this happened near Philadelphia. The psychiatrist was carrying a gun and fired back before the patient could kill others. NPR's Jeff Brady has the story.

JEFF BRADY, BYLINE: Delaware County District Attorney Jack Whelan laid out what happened Thursday afternoon in a psychiatric clinic next to Mercy Fitzgerald Hospital. He says patient Richard Plotts was there to see his psychiatrist, caseworker Barbara Hunt also was there. The DA says Plotts was agitated, wouldn't sit, down pulled out a gun and pointed it at Hunt.

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JACK WHELAN: And fired into her head into the left side of her head, which we believe immediately killed her. That bullet went right into her brain and we believe it was instant death at that point in time.

WHELAN: At that point in time the doctor reached in to his pocket and pulled out a .32 caliber semiautomatic handgun.

BRADY: Whalen says Doctor Lee Silverman had a permit to carry concealed weapon. The DA says the doctor began firing his gun at Plotts, hitting him several times. Shortly after that, staff at the clinic subdued plots and he was taken to hospital for treatment. DA Whelen says Plotts has been kept sedated but will be charged with murder, attempted murder and other charges. Whelen says Plotz had 39 more bullets on him but he never got a chance to use them.

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WHELAN: I believe that if the doctor did not have the firearm, if the doctor do not utilize the firearm, he'd be dead today and I believe that other people in that facility would also be dead and we'd be making funeral arrangements for those individuals.

BRADY: He says the hospital does not allow guns in the building but he says Doctor Silverman did not break any laws by bringing the gun there. Doctor Silverman did not respond NPR's request for an interview. Mercy Fitzgerald Hospital praised Silverman and said in a statement they're reviewing policies and procedures to ensure a safe environment. The case has prompted a discussion in the psychiatric community Murray Shane is a psychiatrist in New York who worship patients who have violent histories.

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MURRAY SHANE: As far as I know, there are no guidelines that I'm aware in the American Psychiatric Association about guns being carried by a psychiatrist. I'd just never heard it come up before.

BRADY: A spokeswoman for the American psychiatric Association Eve Herold said in a statement to NPR that the APA has no official position on unusual situations such as this one and has no comments at this time. Doctor Shane says, despite the outcome in this case he does not think psychiatrist should be carrying guns.

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SHANE: No, I don't think that would be a good idea, I don't see the what the need for them is. This just happened to be a strangely fortuitous situation, I think.

BRADY: He points out there's still a lot we don't know about this case, such as why Doctor Silverman chose to carry a weapon with him while working. Doctor Silverman was injured during the shooting, he was treated for a hurt thumb and a graze wound to his head then released from the hospital. Jeff Brady, NPR News, Philadelphia. Transcript provided by NPR, Copyright NPR.